From the Plastic Surgery, Faculty of Medicine, University of Montréal, Montreal, Quebec, Canada.
Faculty of Medicine, East Tennessee State University, Johnson City, TN.
Ann Plast Surg. 2023 Mar 1;90(3):237-241. doi: 10.1097/SAP.0000000000003463.
Electrical stimulation can accelerate peripheral nerve regeneration after injury and repair. Clinically, direct electrical stimulation (DES) may involve longer operating times, increasing risks of perioperative complications. Transcutaneous electrical stimulation (TCES) is a noninvasive alternative. In this study, we investigate how transcutaneous and DES compare for accelerating functional nerve recovery in a mouse sciatic nerve model.
Twenty-eight mice were divided into sham (n = 4), axotomy (n = 8), DES (n = 8), and TCES (n = 8) groups. After sciatic nerve transection and repair, the proximal nerve was subjected to DES or TCES at 20 Hz for 1 hour. Sciatic functional index was measured before the injury, and at weeks 1, 2, 4, 6, 8, 10, and 12 by walking-track analysis. Electrophysiological measures were taken at week 12.
Kinematic studies showed significant improvement from the 8th week to the 12th week for both electrical stimulation groups compared with the axotomy group (P < 0.05), with no difference between the electrical stimulation groups. At the 12th week, both DES and TCES groups had significantly faster average conduction velocity than the axotomy group.
Functional recovery was significantly better from 8 weeks onward in mice receiving either DES or TCES stimulation when compared with axotomy and repair alone. Transcutaneous electrical stimulation is a minimally invasive alternative treatment for accelerating functional recovery after peripheral nerve injury.
电刺激可以加速损伤和修复后的周围神经再生。临床上,直接电刺激(DES)可能需要更长的操作时间,增加围手术期并发症的风险。经皮电刺激(TCES)是一种非侵入性的替代方法。在这项研究中,我们研究了经皮电刺激和直接电刺激在加速小鼠坐骨神经模型中功能神经恢复方面的比较。
28 只小鼠分为假手术(n = 4)、切断(n = 8)、DES(n = 8)和 TCES(n = 8)组。坐骨神经切断和修复后,将近端神经用 20 Hz 的 DES 或 TCES 刺激 1 小时。在损伤前、第 1、2、4、6、8、10 和 12 周通过步态分析测量坐骨神经功能指数。在第 12 周进行电生理测量。
运动学研究表明,与切断组相比,电刺激组在第 8 周到第 12 周的恢复明显改善(P < 0.05),两组之间没有差异。在第 12 周,DES 和 TCES 组的平均传导速度均明显快于切断组。
与单独切断和修复相比,接受 DES 或 TCES 刺激的小鼠在第 8 周后功能恢复明显更好。经皮电刺激是加速周围神经损伤后功能恢复的一种微创替代治疗方法。